Effect of first smoke of day predicts quit success In a new study, researchers looked at the degree of craving, withdrawal symptoms and mood before and after the day's first cigarette. Those who reported a decrease in cravings after the first smoke were found to have the most difficulty when trying to quit. (Francois Mori/AP Photo) By Anne Harding May 11, 2007 NEW YORK (Reuters Health) - The more the first smoke of the day reduces a person's craving for a cigarette, the harder it will be for that person to quit, a recent study shows. Among smokers participating in a clinical trial of the drug bupropion, an antidepressant that is also used at lower doses as a smoking cessation aid, those who reported the strongest drop in craving after the day's first cigarette had the hardest time kicking the habit, Dr. Benjamin A. Toll of Yale University School of Medicine in New Haven, Connecticut and colleagues found. Toll told Reuters Health that, at present, the findings don't have any applications for helping smokers to quit. "In theory, one long-term goal would be to possibly use this as some kind of a screening test to tell who may have more trouble quitting and maybe needs more medication or stronger dosing or possibly more counseling," he said in an interview. As of now, however, "We're nowhere near this type of treatment matching," he added. The findings come from a report in the medical journal Drug and Alcohol Dependence. Toll and his team recruited 207 smokers for a smoking cessation study. During their first week on bupropion, study participants could continue to smoke, and the researchers gauged their degree of craving, withdrawal symptoms and mood before and after the day's first cigarette. Smokers with the greatest reduction in cravings after the first cigarette were more likely to relapse after six weeks on bupropion, and were also more likely to have relapsed three months after drug treatment had ended. It's possible, Toll suggested, that these smokers were more nicotine-dependent. He and his colleagues conclude that craving reduction after the day's first cigarette could be used as a way to predict relapse risk, but should be studied further in larger groups of patients and with other smoking cessation drugs. SOURCE: Drug and Alcohol Dependence, online February 22, 2007. Copyright 2007 Reuters News Service. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.